DR. MARC A PROVENCHER (NPI# 1184794745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184794745 |
| Entity Type | Individual |
| Full Name | DR. MARC A PROVENCHER |
| Credential | O.D. |
| Practice Address |
4050 Timberline Rd Suite 120 Fort Collins CO 80525-6032 |
| Practice Telephone | 9704728888 |
| Practice Fax Number | 9704728484 |
| Mailing Telephone | 9704728888 |
| Mailing Fax Number | 9704728484 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-01-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
209T | WY | Eye and Vision Services Providers |
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
2025 | CO | Eye and Vision Services Providers |
| Street Address |
4050 TIMBERLINE RD SUITE 120 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-6032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275717266 | Marc A Provencher | Optometrist | 4050 Timberline Rd, Suite 120, Fort Collins, CO 80525-6032 | 2007-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982991550 | Natalie Christine Santelli | Optometrist | 1725 E Prospect Rd, Fort Collins, CO 80525-1307 | 2011-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033637046 | Alpenglow Eye Care, Pllc | Optometrist | 611 24 Rd, Grand Junction, CO 81505-1240 | 2017-08-30 |
| 1386014397 | Jeffrey B Holland Od PC | Optometrist | 1350 College Ave Unit 100, Boulder, CO 80302-7389 | 2015-10-02 |
| 1629353172 | Liz Erley | Optometrist | 3301 30th St, Boulder, CO 80301-1401 | 2011-10-17 |
| 1588860571 | Timothy L. Osius Jr. O.d. Inc. | Optometrist | 2980 Ginnala Dr., Suite A, Loveland, CO 80537-2701 | 2007-06-26 |
| 1194936401 | Ryan Thomas Smedley | Optometrist | 8405 Park Meadows Center Dr Ste 1000, Lone Tree, CO 80124-5025 | 2007-05-25 |
| 1891818316 | Superior Eye Care PC | Optometrist | 9948 W 99th Ave, Westminster, CO 80021-4298 | 2007-04-09 |
| 1639291107 | Johnna C Bontadelli | Optometrist | 917 Clydesdale Ln, Windsor, CO 80550-3135 | 2007-04-04 |
| 1164578373 | Nancy Barnard Smith | Optometrist | 1940 Greeley Mall # 27, Greeley, CO 80631-8520 | 2007-01-28 |
| 1154474187 | Kevin C. Pollard | Optometrist | 1516 Xavier St, Suite 101, Denver, CO 80204-1024 | 2007-01-21 |
| 1073527206 | Edward P Williams | Optometrist | 123 Madison St, Suite 100, Denver, CO 80206-5434 | 2006-07-27 |
| Find all providers with the same taxonomy | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
Please comment or provide details below to improve the information on DR. MARC A PROVENCHER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.